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General NPI Number Information
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NPI Number | 1629062393
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Entity Type | Individual
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Provider Name | RATNAMANI LINGAMALLU M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/08/2005
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 515 E GARDEN ST
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City | LAKELAND
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State | FL
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Zip | 33805-4615
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Country | US
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Telephone | 863-683-5454
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Fax | 863-683-4652
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Provider Business Mailing Address
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Address Line | PO BOX 878
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City | DAVENPORT
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State | FL
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Zip | 33836-0878
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Country | US
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Telephone | 689-223-3898
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Fax | 689-223-3898
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME66958
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | ME66958
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | ME66958
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License Number State | FL
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